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Typhoid and paratyphus And yes In — the general acute feverish diseases which are characterized by a cyclic current with intoxication phenomena, rozeolezno-papular rash, a canker of the lymphatic device of intestines.
Etiology. Activators — gram-negative, mobile bacteria from a genus of salmonellas. Sticks of a typhoid and a paratyphoid And pathogens only for the person, and and are much more rare than a paratyphoid stick In pathogens for the person — for animals. Microbes of tifo-paratyphoid group are steady in external environment. Disinfectants in usual concentration kill them within several minutes.
Epidemiology. A source of an infection are patients and bacillicarriers. In certain cases infection with a paratyphoid can occur through meat of the lethal animals and birds affected with this infection. Factors of transfer are water, foodstuff, household contact in the conditions of disturbance of the sanitary and hygienic mode. The possibility of distribution of an infection through flies is not excluded.
Pathogeny. Getting into intestines, the activator is implemented into lymphatic formations of a mucous membrane of intestines, lymph nodes of a mesentery, and then gets into a blood stream that leads to development of a typhus state.
Secondary bacteremia proceeds in the conditions of the allergized organism. Tells the inflammatory and necrotic process, characteristic of an allergy, in the lymphatic device of intestines which is shown formation of ulcers in a large intestine about it. During generalization of infectious process, from the first days of an illness, the positive hemoculture can be received.
Clinic. The incubation interval from 1 to 3 weeks, at a paratyphoid In it is much shorter. Course of a disease, as a rule, gradual: there is the general weakness, appetite and a dream worsen, the headache amplifies, body temperature increases, reaching to 5 — to the 7th day of 39 — 40 °C. In recent years probably under the influence of the amplifying influences of allergenic factors the acute onset of the illness prevails. At a paratyphoid In it especially clearly it is expressed. The typhus status in the heat of an illness is typical for this infection, but since use of effective causal antibiotic treatment this symptom began to be expressed more weakly. Pallor of skin, relative bradycardia, reinforced language with prints of teeth and hypertrophied nipples are characteristic. Typical displays of an illness are the meteorism, a positive symptom of Padalki (a dullness in ileocecal area). With 7 — the 9th day of an illness on skin of a trunk there is scanty rozeolezny rash, more plentiful at a paratyphoid of Century. From roseolas it was possible to sow culture of the activator with the same frequency, as well as at crops of a venous blood on a hemoculture. The spleen and a liver are increased. In lungs scattered dry rattles are listened. Since the end of the 2nd week the frequency and character of a chair can change. Since use of etitropny therapy diarrhea is observed only at 20 — 25% of patients. The next and remote recurrence which is followed by a repeated wave of fever, deterioration in the general state and repetition of all symptoms inherent in a typhoid is possible. During this period from blood the disease-producing factor is allocated.